Prevalence of high-sensitivity C-reactive protein testing among US patients with atherosclerotic cardiovascular disease with or without chronic kidney disease
Publication Title
American College of Cardiology Annual Scientific Session and Expo, April 6-8, 2024, Atlanta, GA
Document Type
Abstract
Publication Date
4-2024
Keywords
oregon; cards; cards abstract
Abstract
Background
Inflammation is known to contribute to the development and progression of both atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD). While high-sensitivity C-reactive protein (hsCRP) is an inflammatory biomarker used for cardiovascular risk assessment in primary prevention, the frequency with which it is measured in secondary prevention is not well understood.
Methods
We performed a cross-sectional analysis of USA adults (≥18 years) with ASCVD between January 1, 2017 and December 31, 2021 using electronic health record data (Optum). Prevalence of hsCRP testing was estimated by calendar year and stratified by presence and severity of CKD. Comorbidity and medication usage were assessed and compared between those that did and did not undergo hsCRP testing, stratified by presence and severity of CKD.
Results
A total of 1,658,476 patients with ASCVD were identified. The proportion per calendar year with any CKD ranged from 44.9% to 68.8%, and those with stage 3-4 CKD ranged from 14.9% to 18.9%. Overall, 0.92% of patients with ASCVD underwent hsCRP testing during the 5-year period (proportion per calendar year ranged from 0.87% to 0.98%), with no appreciable difference in the proportion of hsCRP testing among those with any CKD (0.97%; calendar year rate ranged from 0.92% to 1.17%) and those with stage 3-4 CKD (1.14 %; calendar year rate ranged from 0.99% to 1.41%). Patients with ASCVD that underwent hsCRP testing were younger and with fewer comorbidities compared with untested patients, regardless of CKD level. Significantly more hsCRP-tested patients with ASCVD, with or without stage 3-4 CKD, received cardiovascular medication, regardless of type (except for digoxin), compared with untested patients (p<0.05).
Conclusion
We identified a persistent, low rate of hsCRP testing in a cohort of secondary-prevention patients, with no appreciable increase among those with CKD. This finding highlights the need for greater hsCRP testing if future anti-inflammatory therapies (that are dependent on hsCRP testing to determine treatment eligibility) are shown to improve cardiovascular outcomes.
Footnotes
Poster Contributions
Hall B4-5
Sunday, April 7, 2024, 10:15 a.m.-11:00 a.m.
Session Title: 1372: Prevention and Health Promotion: Diabetes and Cardiometabolic Disease 09
Abstract Category: 37. Prevention and Health Promotion: Diabetes and Cardiometabolic Disease
Presentation Number: 1372-209
Area of Special Interest
Cardiovascular (Heart)
Area of Special Interest
Kidney & Diabetes
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Endocrinology
Specialty/Research Institute
Nephrology
DOI
10.1016/S0735-1097(24)03882-8